Are Annual Exams Really Necessary?

Last year, in a much-discussed New York Times article titled "Let’s (Not) Get Physicals," a physician reporter named Elisabeth Rosenthal argued that annual physical examinations for human patients are pointless. She cited a Canadian government task force recommendation to abandon annual physical examinations because they are “nonspecific,” “inefficient” and “potentially harmful” (in that they may lead to unnecessary tests). The task force said examinations should be replaced with intermittent screening tests for age- and risk-specific conditions (mammograms, Pap tests, etc.). Dr. Rosenthal argued that this logic is sound in the United States as well.

Scrutiny of annual physical examinations for people does not come as a surprise. Health care costs are soaring, and research consistently shows annual physicals don’t save lives. Most treatment is started because a patient feels sick and comes to the doctor — not because of findings in a routine examination.

So, do these human-side rumblings mean that we should re-evaluate the annual or biannual examinations that veterinarians recommend for pets? Are those trips to the vet with seemingly happy, healthy pets really worth the stress and effort for all involved? I’ve asked myself those questions repeatedly. Here are the key points I always return to.

Patient Risks and Lifestyles Change

The strongest argument I have heard for continuing annual physical examinations on the human side of medicine has nothing to do with taking temperatures, running lab tests, listening to chests or asking patients to turn their heads and cough. The single most important reason for a physical examination is making time to review patients’ medical histories and to discuss health risks associated with their individual lifestyles and activities.

Likewise, these discussions in regard to pets have great benefit, I believe. Vaccination decisions, food choices, exercise routines, parasite control products and behavioral training measures should all be based on each pet’s lifestyle. The activities that your pet participates in, the environment where he or she lives and his or her specific health risks all change over time and with age. These issues need to be reviewed with a veterinarian on a regular basis to help ensure long-term wellness.

History Is Important

Understanding what is “normal” for a pet is of great importance when veterinarians are faced with potentially abnormal findings. When I treat patients who have not been to a veterinarian for extended periods of time, I find myself wondering things like “Is this pet losing weight? If so, how much?” and “Are these blood chemistry levels increasing?” The unfortunate truth is that if no one has investigated or recorded these values previously, I don’t have any basis for comparison. That makes finding meaningful health trends more difficult. Having routine examinations helps establish a normal baseline for each pet, making it much more obvious when something happens that is abnormal.